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Judgment
THE challenge in this appeal is to the order of the learned District Forum, Solan, dated 11.3.93 whereby the complaint of the appellant/complainant (hereinafter to be referred to as the complainant) has been dismissed.
IN the complaint, the complainant, who is the wife of late Shri Krishan Parkash Goyal, the insured, has prayed for the recovery of Rs. 30,000/-on the strength of insurance policy which has accrued to her after the death of her husband. She has also claimed interest @ 18% per annum from the date of death of her husband till actual payment and also damages of Rs. 15,000/-. There is no dispute that late Shri Krishan Parkash Goyal was the husband of the complainant and that he died on 13.12.90. There is further no dispute that the husband of the complainant died at Nahan on account of heart attack. Shri Krishan Parkash Goyal was employed as Junior Engineer in the office of Executive Engineer, Irrigation & Public Health, Nahan. There is also further no dispute that late Shri Krishan Parkash Goyal was insured with the respondents (hereinafter to be referred to as the Life Insurance Corporation) for a sum of Rs. 30,000/-and at the relevant time on 30.12.90 when Shri Krishan Parkash Goyal died because of heart attack, the insurance policy was in force.
The claim of the complainant has been repudiated by the Life Insurance Corporation on the ground that at the time of insurance, while filling-in proposal form, Shri Krishan Parkash Goyal did not disclose that he was suffering from heart trouble and as such has concealed material facts and, therefore, in terms of the contract of insurance, the complainant is not entitled to any insured amount, as according to the Life Insurance Corporation, the contract of insurance is entered into essentially in good faith and it is required of the insured to reveal all ailments he was suffering at the time or before filling-in the proposal form for life insurance.
MRS. Ranjana Parmar, learned Counsel for the complainant not only has relied upon the report of the Doctor of the Life Insurance Corporation Dr. Peter D''Souza but also has submitted very strenuously that neither there is evidence in the form of affidavit in support of the version of the Life Insurance Corporation nor any documents have been proved as required under the law an4 no notice should have been taken of such documents. The District Forum has wrongly dismissed the complaint by having relied upon such documents. On the other hand Mr. Subhash Sharma, learned Counsel for the Insurance Company has very strenuously contended that while filling in the proposal form at the time of insurance, it was the duty of the life insured to reveal all ailments including heart trouble from which the life-insured was suffering at the time of insurance and that since the complainant has deliberately concealed such facts from the Life Insurance Corporation, he has committed a breach of faith and under .the .contract of insurance he is not entitled under law to any money on the strength of insurance policy, Further, the documents have been properly proved and it was not necessary to produce the evidence as the version of the documents produced by the Life, Insurance Corporation has, been admitted by the complainant. In order to appreciate the rival contentions of the parries, we may at the very outset observe that we do not find any material on the record to show that the documents produced on record by the Life Insurance Corporation have been admitted by the complainant. Such argument has been made merely to be rejected
FURTHERMORE, there is absolutely no evidence whatsoever in the form of affidavit or otherwise to demonstrate the version of the Life Insurance Corporation. The Life Insurance Corporation have only filed reply but not produced any evidence. In spite of that, we have gone into the documents produced by the Life Insurance Corporation. There is one certificate dated 8.1.88 (Annexure R-4) issued by Dr. Satish Korla, G.A.M.S., according to whom, the complainant was under his treatment from 4.1.88 to 8.1.88 for some disease. It is not clear from this certificate as to what specific disease the Doctor is referring to Further it is also not clear whether Dr. Satish Korla, who is G.A.M.S., had the means to find whether or not the deceased was suffering from the disease. The documents Annexure R-5 and R-6 produced by the Life Insurance Corporation are of Civil Hospital, Dharamshala, which reveal that Krishan Parkash Goyal might be suffering from ''Unstable Angina'' or some heart ailment. There is another document, Annexure, R7, of Sain Homeo Clinic Dharamshala, which also refers to hypertension which the husband of the complainant was suffering from. Another document, Annexure R-8, is of Nitin Nursing Home, Patiala. These documents have been relied upon by the District Forum, although specifically it has not referred to any documents. These documents could not have been relied upon by the District Forum for various reasons. First, these documents are not supported by any evidence, whatsoever, not ; even by a simple affidavit by the Manager of the Life Insurance Corporation or any other officer authorised by the said Corporation. FURTHERMORE, these documents, have simply been placed on record and. even if for arguments sake, these documents are proved on record, their truth or correctness, or otherwise has to be ascertained from the evidence as a whole and the contents thereof cannot i be accepted, as it is. FURTHERMORE, even the originals have not been produced nor has been shown that these documents are the true copies of the originals. We are of the opinion that only in case the Doctors who have given their opinion -expert opinion - had supported their versions by means of an affidavit or otherwise in examination before the Court, only then the evidence regarding; the ailment of the patient could have been given weight. It is settled law that the opinion of the Doctor - an expert - unless he is subjected to the test of examination and cross-examination in a Court, such evidence cannot be considered as authentic and such evidence cannot be relied upon and form the basis of a finding. Merely the insured has availed of medical leave during his service does not establish at all that he was having a heart trouble. It is common knowledge that a person can die of heart attack ail of a sudden without having prior knowledge. Another significant aspect of the matter may also be noticed that Dr. Peter D''Souza, admittedly, the Doctor of the Life Insurance Corporation, has given opinion that at the time when the contract of insurance was entered into or the proposal form was filled up, the complainant''s husband was not suffering from any heart; ailment. There is no reason to disbelieve his opinion particularly when he is the Doctor of the Life Insurance Corporation. The judgment of; the District Forum is, therefore, liable to be set aside, as it suffers from errors of law, and is accordingly set aside. The Insurance Company is directed to pay Rs. 30,000/-to the complainant; The complainant shall also be entitled to interest @ 18% per Annum from the date of death i.e. with effect from 30.12.90 till actual payment. There is no orders as to costs. The amount shall be paid within four weeks. Appeal allowed.